Pharmacotherapy is a vital part of the multi-pronged strategy in dementia management. All dementia patients should be evaluated for suitability of pharmacological strategies to address the underlying disease, enhance cognitive symptomatology, and treat attendant behavioural complications. Once a definitive diagnosis of dementia has been made, the choice of symptomatic treatment hinges mainly on dementia etiology and stage of severity. While skilful use of symptomatic treatment can offer tangible but modest benefits in many cases, the decision to initiate such costly treatment should be individualized and always made in conjunction with the patient and caregiver. In future, disease-modifying treatment which goes beyond a primary symptomatic effect to target the underlying disease process may be available.